29828

Release of tendon connecting biceps muscle and shoulder using an endoscope

Medicare pricing data for 7,961 providers across 52 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $5,462 but Medicare allows only $943.51. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Prices vary significantly by location — from $217 in Vermont to $1,367 in California. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Release of tendon connecting biceps muscle and shoulder using an endoscope (HCPCS code 29828) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $943.51, but hospitals typically charge $5,462 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$188.70

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $943.51, your out-of-pocket cost would be approximately $188.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$943.51
Average Hospital Charge
$5,462
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,461.67
Medicare Allowed$943.51
Medicare Payment$751.94

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $751.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$1,367$7,3046583,322+44.9%
Delaware$1,277$6,00928127+35.4%
Alaska$1,274$8,75726117+35.1%
Washington$1,209$3,7941881,093+28.2%
Maryland$1,203$8,488147802+27.5%
Mississippi$1,173$6,14266880+24.3%
Tennessee$1,162$6,4381871,124+23.2%
Hawaii$1,158$3,51624119+22.7%
New Mexico$1,144$4,8472774+21.2%
Connecticut$1,119$5,72495379+18.6%
Virginia$1,091$6,0721911,519+15.7%
Oregon$1,089$3,97195644+15.4%
Nevada$1,048$5,55872427+11.1%
Arizona$1,043$5,3991931,042+10.6%
New Hampshire$1,037$7,34162221+9.9%
Rhode Island$1,037$5,5342875+9.9%
Minnesota$1,034$5,167142463+9.6%
District of Columbia$997$5,2581486+5.7%
Georgia$993$5,8532411,175+5.2%
Colorado$986$5,338170817+4.5%
Michigan$980$5,829224982+3.8%
Utah$973$5,11695687+3.1%
Florida$954$6,2815803,028+1.1%
Indiana$950$5,658151527+0.6%
Missouri$945$5,6411651,089+0.2%
Puerto Rico$941$1,3671749-0.3%
North Carolina$920$4,1562902,103-2.5%
New Jersey$906$10,823230823-4.0%
New York$906$6,4624351,598-4.0%
Illinois$898$6,5752881,279-4.8%
Texas$870$5,4305142,505-7.8%
Montana$838$2,16238295-11.2%
Iowa$826$3,49183349-12.5%
Pennsylvania$799$4,1863141,286-15.3%
South Carolina$773$4,3741601,234-18.1%
Massachusetts$771$4,906196996-18.3%
Ohio$753$3,9282941,396-20.2%
Alabama$726$2,867145704-23.1%
Arkansas$696$3,46582489-26.2%
Wyoming$695$4,11628116-26.4%
Kansas$675$5,310114705-28.4%
Kentucky$673$3,779102494-28.7%
Louisiana$673$4,485127732-28.7%
Idaho$644$3,85174354-31.8%
North Dakota$635$3,01512113-32.7%
West Virginia$561$3,08545136-40.5%
Wisconsin$546$7,609158543-42.1%
Oklahoma$532$2,046106590-43.6%
Nebraska$516$3,12775352-45.3%
Maine$347$1,83947112-63.2%
South Dakota$263$2,09649290-72.1%
Vermont$217$2,0311129-77.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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